A case report of primary central nervous system lymphoma

Abstract

Most patients with primary central system lymphoma (PCNSL) have immune dysfunction. PCNSL without immune dysfunction is rare and extremely challenging to diagnose. Here, we report the case of a 52-year-old woman without immune dysfunction who presented with PCNSL. The patient died a few months after diagnosis and during treatment. A review of this PCNSL patient’s case highlighted that poor interpretation of imaging features and the poor correlation of laboratory test results with clinical findings led to a difficulty in making a diagnosis and administering the best treatment. For an accurate diagnosis of early stage PCNSL, positron-emission tomography computed tomography and corticosteroids should be used cautiously before stereotactic biopsy.

Primary Large B-Cell Lymphoma of Immune-Privileged Sites of the Cerebellum: A Case Series and Review of the Literature

“…This may constitute a relevant diagnostic pitfall for lymphoma (i.e., “steroid-mitigated lymphoma”), as observed in two cases included in our review [ 15 , 25 ]. Even though steroid is useful in reducing the burden of symptoms, they change the radiographic and histopathological appearance potentially affecting diagnosis [ 26 ]. Moreover, in our cohort of patients, none of the patients who receive neoadjuvant steroid therapy died, compared to 40% of deaths in patients who do not receive neoadjuvant steroids.…”

Primary CNS Lymphoma Mimicking Tuberculosis Infection - A Case Report

“…There is strong evidence that PET-CT is superior to conventional MRI in diagnosing PCNSL and other CNS tumors. 10 PET-CT facility was not available in our setting because of which differentials were made with the help of MRI imaging. One of the important things that come into account is that corticosteroids always be used with caution before the definite diagnosis in case of CNS pathologies because they may interfere with the accuracy of the biopsy.…”

Case series on patients with primary central nervous system lymphoma: From clinical presentations to outcomes

“…Primary central nervous system lymphoma in brain MRI reveals iso‐ or hypointense signals in T1‐weighted images, iso‐ or slightly hyperintense signals on T2‐ weighted images, hyperintense signals on FLAIR images, and plaque enhancement on gadolinium contrast‐enhanced images. 17 It is typically located in the supratentorial region, and the most common areas of involvement include the cerebral hemispheres, basal ganglia, thalamus and corpus callosum. 18 Eight of our patients had a tumor in the cerebral hemispheres, and the other involved sites were the thalamus, corpus callosum, and cerebellum.…”